Related Experiment Videos
Experience with pneumocystis carinii pneumonia in patients with AIDS
R J Ingram1, R Davis, R B Ellis-Pegler
1Department of Radiology, Auckland Hospital.
Abstract:
We have reviewed admission data, some diagnostic tests, treatment and outcome of 31 male homosexual patients infected with the human immunodeficiency virus with 37 consecutive episodes of presumptive Pneumocystis carinii pneumonia treated at the infectious disease unit, Auckland Hospital, between 1985 and 30 June 1988. The median age was 39 years. Eight episodes were proven Pneumocystis carinii pneumonia, 18 satisfied Centres for Disease Control criteria for presumptive Pneumocystis carinii pneumonia and 11 lacked one Centres for Disease Control criterion. Patients began intravenous or oral cotrimoxazole in 32 episodes, initially 20 mg/k/d of trimethoprim component, but since early 1988 10 mg/k/d. In nine episodes treatment was changed to intravenous pentamidine because of side effects or failure to respond while five received pentamidine as their only drug. Cotrimoxazole caused side effects in 20 of 32 episodes (rash in 11) and pentamidine in 10 of 14 (renal impairment in nine). Two patients died (ie, a 5% mortality for all 37 episodes or 8% for 26 proven and Centres for Disease Control presumptive episodes). Median hospital stay for survivors was 11 days. Fourteen other patients have subsequently died a median eight months after the initial episode. Pneumocystis carinii pneumonia is an important infection in patients infected with the human immunodeficiency virus.
Insights
Pneumocystis carinii pneumonia is a significant infection in individuals with human immunodeficiency virus (HIV). Early treatment with cotrimoxazole or pentamidine is crucial, though both have notable side effects.
Area of Science:
- Infectious Diseases
- Immunology
- Public Health
Background:
- Human immunodeficiency virus (HIV) infection predisposes individuals to opportunistic infections.
- Pneumocystis carinii pneumonia (PCP) is a common and serious opportunistic infection in HIV-positive patients.
- Understanding PCP treatment outcomes in HIV patients is vital for clinical management.
Purpose of the Study:
- To review the treatment and outcomes of Pneumocystis carinii pneumonia (PCP) in HIV-infected patients.
- To evaluate the efficacy and side effects of cotrimoxazole and pentamidine for PCP treatment.
- To assess the mortality associated with PCP in this patient population.
Main Methods:
- Retrospective review of 37 consecutive PCP episodes in 31 HIV-infected male homosexual patients.
- Analysis of admission data, diagnostic tests, treatment regimens (cotrimoxazole, pentamidine), and patient outcomes.
- Categorization of PCP episodes based on diagnostic certainty (proven, presumptive CDC criteria met, presumptive CDC criteria not met).
Main Results:
- PCP is a significant infection in HIV patients, with a 5% mortality rate across all episodes reviewed.
- Cotrimoxazole was the primary treatment, causing side effects in 63% of cases (11/32 with rash).
- Pentamidine was used in 14 episodes due to side effects or treatment failure, causing renal impairment in 9 of 14 patients.
Conclusions:
- Pneumocystis carinii pneumonia remains a critical infection for individuals with human immunodeficiency virus.
- Both cotrimoxazole and pentamidine are associated with significant side effects, necessitating careful monitoring.
- Further research into optimal PCP management in HIV patients is warranted to improve outcomes.